Abstract

Study objectives: Incomplete follow-up can bias
interpretation of data that are collected in longitudinal studies. We
noted that many patients failed to return for follow-up in a study of
effect of lung volume reduction surgery (LVRS) on quality of life
(QOL). Accordingly, we designed this investigation to determine the
reasons patients dropped out, and to assess differences between those
who continued in the study (attendees) and those who did not
(nonattendees).

Design: Telephone survey.

Subjects: Patients with advanced emphysema who had
undergone LVRS and had previously agreed to participate in a
longitudinal QOL study.

Results: No differences were
found with regard to age, gender, preoperative pulmonary function, or
oxygen use between attendees and nonattendees. Long-term mortality in
nonattendees (27%) was considerably greater than that seen in
attendees (3%, p < 0.05). Distance from the hospital, financial
burden, and living out of the region were the most common reasons cited
by surviving nonattendees for their failure to return for
follow-up.

Conclusions: Studies reporting the
long-term mortality after LVRS can be biased in the direction of
underestimating the true value if they are compromised by incomplete
follow-up.

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